Further evidence for the case against neuropsychoanalysis: How Yovell,Solms, and Fotopoulou's response to our critique confirms the irrelevance and harmfulness to psychoanalysis of the contemporary neuroscientific trend

In their paper “The case for neuropsychoanalysis” Yovell, Solms, and Fotopoulou (2015) respond to our critique of neuropsychoanalysis (Blass & Carmeli, 2007), setting forth evidence and arguments which, they claim, demonstrate why neuroscience is relevant and important for psychoanalysis and hence why dialogue between the fields is necessary. In the present paper we carefully examine their evidence and arguments and demonstrate how and why their claim is completely mistaken. In fact, Yovell, Solms, and Fotopoulou's paper only confirms our position on the irrelevance and harmfulness to psychoanalysis of the contemporary neuroscientific trend. We show how this trend perverts the essential nature of psychoanalysis and of how it is practiced. The clinical impact and its detrimental nature is highlighted by discussion of clinical material presented by Yovell et al (2015). In the light of this we argue that the debate over neuropsychoanalysis should be of interest to all psychoanalysts, not only those concerned with biology or interdisciplinary dialogue.     

Our Literature as the Problem Child of Psychoanalysis Commentary on Paper by Drew Westen

This paper is a response to an essay by Drew Westen. The author agrees with many of Westen's arguments about problems in the psychoanalytic literature and adds that the psychoanalytic literature has always been a problem for psychoanalysis. If we think of psychoanalysis as an ongoing experiment, then its “trials” are all the analytic sessions that have been conducted. Our “literature” has never systematically drawn on those. Westen critically scrutinizes certain habits that, in his view, haunt our literature, but that we do not explicitly note or disown as conceptual contrivances we mean to get rid of, while they are often misguiding clinical thinking and practice. I suggest that a fascinating question riding below the waves of Westen's paper is why patients and analysts accept this situation. I suggest that we all treat psychoanalysis as wisdom, art, relationship, skill, and something other than the application of established scientific findings because we recognize and accept it as that kind of human activity. It is unclear if patients care whether or not their analysts are scientists, but it is clear that analysts are not optimistic about sifting the research literature and finding clear clues to more effective clinical thinking, work, or writing.     

Organizational Structure and the Establishment of Psychoanalytic Identification: Commentary on Paper by Randall Lehmann Sorenson

This commentary addresses two themes: parallels between religious and psychoanalytic education and the question of group survival in a world of competitive groups, whether religious (“strict” vs. “weak”) or psychoanalytic (differing psychoanalytic approaches). “Strict” religious education involves teaching both critical thinking and identification with the particular religion. This blend of critical thinking and identification with psychoanalysis is crucial in psychoanalytic education. We want to graduate students who see themselves as psychoanalysts rather than as being “interested” in psychoanalysis. This goal is accomplished when students have close, positive experience with personal analysts, supervisors, and teachers who are strongly committed to psychoanalysis but in a manner that encourages students to think critically and find their own psychoanalytic perspective. With regard to the second theme, I discuss how our narcissistic commitment to one or another psychoanalytic model interferes with open integration of new insights. Individual analysts privately integrate competing ideas in their own idiosyncratic ways. When these individuals publicly represent competing psychoanalytic groups, however, they tend to emphasize differences among these groups. They then find ways to appropriate new ideas as extensions of their own evolving tradition. In this way, a theoretical school is able to integrate new developments while preserving its own identity.     

Seeking an Analytic Identity

Abstract

Rothstein has stimulated all analysts to rethink how we can better commit ourselves to our analytic work. In this paper I focus on factors in analysts' personalities and experiences in their training and practice that contribute to or distract from establishing an analytic identity.

First, I explore analysts' background and motivation. In admissions to psychoanalytic institutes we look for candidates who can see psychoanalysis as an intellectual puzzle to be solved and an emotional involvement to be experienced. We look for earlv conflicts that the candidate can sublimate in the service of analytic functioning. We assume that the capacity to sublimate is only partial and that analysts in their development continue to recognize conflicts in transference—countertransference reactions.

Second, I give some examples of experiences from analysts' training that stimulate the formation of their analytic identities. These include transient identifications and counter-identifications with the training analyst, supervisor, seminar leader, and favorite analytic authors.

Third, I discuss more external factors that influence the development of analytic identity. These include the climate in training and continuing education at the institute. How much does the institute support its members in immersion in psychoanalysis? Economic factors continue to he an important factor in determining individual choice in this immersion.

Finally, I review studies on the effectiveness of psychoanalysis. Dedicated analysts with considerable experience believe that analysis works despite some limitations. Part of high motivation to continue analytic work includes understanding how analytic results differ from the simpler solutions achieved by nonanalytic therapies.     

Being a psychoanalyst: An everyday audacity1

This paper is the work of fi ve psychoanalysts who came together as a group in order to refl ect on their work as analysts. How are we analysts to identify the unconscious resistances that may sometimes hold us back from offering psychoanalysis to some patients? Do these resistances sometimes hamper the inner freedom that we require in order to maintain a psychoanalytic focus once that process is under way? How do we manage from time to time to overcome these resistances or, better, make use of them in order to develop our understanding of the unconscious dynamics that create the link between analyst and patient? The authors discuss these issues with particular reference to clinical situations taken from classic psychoanalytic treatment cases during which the analyst had to fi nd within him‐ or herself the audacity to be a psychoanalyst. Each clinical situation is different: preliminary interviews, in the course of the actual treatment, issues that emerge in the training of candidates. One of the signifi cant features of this group lies in the fact that the participants are at different stages in their development as psychoanalysts (student, associate member, full member, training analyst). This means that their experiences complement one another and encourage a discussion of issues such as how psychoanalysis can be passed on, and the relationship between supervisor and supervisee.     

On neuropsychoanalytic metaphysics

Neuropsychoanalysis focuses on the neural counterparts of psychoanalytically interesting phenomena and has left the difference in the metaphysical presuppositions between neuroscience and psychoanalysis unexamined. The authors analyse the logical possibilities concerning the relation between the brain and the mental unconscious in terms of the serial, parallel, epiphenomenalist and Kantian conceptions, and conclude that none of them provides a satisfactory ground for neuropsychoanalysis. As far as psychoanalytic explanations refer to the mental unconscious, they cannot be verified with the help of neuroscience. Neither is it possible to form a picture of how a neuro-viewpoint might be of help for psychoanalytic theorizing. Neuropsychoanalysis has occasionally been seen as a reductionist affair, but the authors suggest that neuropsychoanalysts themselves lean on the hybrid conception, which combines neuroscientific and psychoanalytic viewpoints. The authors state arguments in favour of the interfield conception of neuropsychoanalysis that takes seriously the metaphysical tensions between neuroscience and psychoanalysis.     

The psychoanalytic process

Analysts differ in how they conceptualize the psychoanalytic process, according to their understanding of the psychoanalytic theory of mental functioning in general and the nature of pathogenesis in particular. Emphasizing that psychoanalysis is a psychology of mental conflict, the authors see the psychoanalytic process in terms of the dynamic interplay between the manifestations of the patient's unconscious and the analyst's interventions. What analysts communicate to analysands serves to destabilize the equilibrium of forces within the mind, leading to the analysands' growing understanding of the nature of their conflicts and how they deal with them. Psychoanalytic process, accordingly, cannot be distinguished or separated from psychoanalytic technique.     

Therapeutic technique in psychoanalysis and psychoanalytic psychotherapy.

As the distinctions between what we consider to be psychoanalysis and what we consider to be psychoanalytic psychotherapy have become more uncertain and more blurred, it follows that it is equally difficult to designate the techniques that would be appropriate and specific for each modality. The problem has been compounded by the fact that in recent years psychoanalysis in the United States has become considerably less homogeneous than in the past and the ego-psychological structural model is no longer the only point of view in the psychoanalytic marketplace. Further, with alterations in the criteria for analyzability, cases which, generally, had not been viewed as suitable for analysis, have been appearing with increasing frequency on psychoanalysts' couches. We have also recognized that the degree of congruence between our expectations from and the results of psychoanalytic treatment was often less than anticipated. It appears that analysts have become considerably less arbitrary about what psychoanalysis is and how a psychoanalysis can be carried out. The author is unable to delineate one technique that is intrinsic to and limited to psychoanalysis. There are, however, differences in degree and emphasis in the ways in which various techniques are applied in the therapy of psychoanalysis as compared to the therapy of psychoanalytic psychotherapy. Special attention is given to the role of a psychoanalytic process and the central place the analysis of resistance plays in psychoanalytic therapy.     

Catching the wrong leopard: courage and masochism in the psychoanalytic situation

This paper introduces the subject of courage into the psychoanalytic discourse about masochism and also demonstrates that ordinary ethical and axiological concerns can and should be included in our psychoanalytic language and practice. At each stage of a psychoanalysis, it may be helpful to consider whether the patient's experience might be that taking a step deeper into the psychoanalytic relationship is both courageous and masochistic. This consideration can open the door to exploration of conscious beliefs and how they are related to unconscious fantasies and assumptions. Considering the possibility that even a sadomasochistic enactment may simultaneously represent a courageous attempt to rework conflict or trauma can enrich the way analysts listen to both manifest and latent material.     

The Quest for a Unified Psychoanalytic Theory: A Retreat from Uncertainty

There has been a historical shift in psychoanalysis from an earlier time of certainty to our present state of uncertainty with the coexistence of multiple theories competing for our attention. We realize retrospectively how entrenched groups ruled our institutions by maintaining faith in their authority as the keepers of “pure” psychoanalysis. Despite struggles between competing ideologies, there has been progress in integrating clinical theories. As no psychoanalytic theory or technique has been proved superior, we advocate an inclusive approach with all psychoanalysts keeping an open mind about the value of competing theories. This integration of disparate theories has led to a resurgence of interest in psychoanalytic training. Examples are given of some of the difficulties encountered when competing ideas are introduced in psychoanalytic groups.     

Brief communication: a comparison of the place of dreams in institute curricula between 1980-1981 and 1998-1999.

The analysis of dreams was central in demonstrating Freud's theory of mind and the power of unconscious forces. Many analysts informally comment that dreams no longer seem to hold the same centrality they had for analysts who were trained prior to the 1980s. This paper presents a brief study assessing whether there has been a change in the teaching of dreams in psychoanalytic institutes. Comparison of theoretical and clinical courses on dreams in 1980-1981 and 1998-1999 indicates that the actual number of hours devoted to teaching dreams has in fact decreased. However, there are indications that a renewal of interest in dreams may now be occurring, at least in some institutes. The relationship between views on the role of dreams and perspectives on psychoanalysis itself is discussed.     

Affirming 'That's not psycho-analysis!' On the value of the politically incorrect act of attempting to define the limits of our field

This paper is concerned with the value of the act of defining the field of psychoanalysis. It examines the reasons why adopting and especially giving voice to a definition that excludes approaches considered by some analysts to be analytic is commonly regarded as unacceptable within psychoanalytic discourse. It then explains the value and advantages of putting forth exclusive definitions. The author argues that clarifying the pros and cons of such acts of definition contributes to the understanding of the nature of psychoanalysis and the possibility of dialogue between opposing understandings of it. It may also contribute to greater freedom of thought and expression which is essential to the development of psychoanalytic theory and practice.     

Re-reading "Little Hans": Freud's case study and the question of competing paradigms in psychoanalysis

Psychoanalysts have long recognized the complex interaction between clinical data and formal psychoanalytic theories. While clinical data are often used to provide "evidence" for psychoanalytic paradigms, the theoretical model used by the analyst also structures what can and cannot be seen in the data. This delicate interaction between theory and clinical data can be seen in the history of interpretations of Freud's "Analysis of a Phobia in a Five-Year-Old Boy" ("Little Hans"). Freud's himself revised his reading of the case in 1926, after which a number of psychoanalysts--including Melanie Klein, Jacques Lacan, and John Bowlby--reinterpreted the case in the light of their particular models of the mind. These analysts each found "evidence" for their theoretical model within this classic case study, and in doing so they illuminated aspects of the case that had previously been obscured, while also revealing a great deal about the shifting preoccupations of psychoanalysis as a field.     

神经精神分析学对压抑机制的研究简析

神经精神分析学是一门试图将神经科学与精神分析学结合起来的学科, 作为一个新兴的领域, 在其成立的短短10年中, 已取得了丰硕的研究成果。为精神分析学这拥有一百年历史的学科带来了新的生机。对精神分析的基石——压抑的研究是神经精神分析学的热点。神经科学家试图从不同角度证明精神分析中压抑这一过程确实是存在的, 而且还存在相应的神经基础, 但是, 目前神经精神分析学的研究还存在一些局限。     

The enduring presence of Heinz Kohut: empathy and its vicissitudes

This paper expands upon and further develops the centrality of empathy in psychoanalysis as offered by Heinz Kohut. Using clinical examples, it differentiates sustained empathy as the distinctive component of psychoanalysis, and it demonstrates some of the difficulties in determining the boundaries of empathy in the practice of psychoanalysis. A further distinction is from mind reading, a purely cognitive exercise, as is intuition (Carruthers 2009). To pursue a psychoanalytic perception of empathy one must confront its limitations and go beyond the somewhat simplistic claim of its unquestioned therapeutic effect. Empathy is more than a cognitive act, and as sustained over time it can be difficult to achieve, can be misunderstood, and can at times have no therapeutic effect.     

Group affective learning in training for psychotherapy and psychoanalysis

This paper describes The Group Affective Model, a method for teaching psychoanalytic concepts and their clinical application, using multi‐channel teaching, process and review in group settings, and learning from experience in an open systems learning community for psychoanalysts and psychotherapists. This innovation arose in response to criticism of existing methods in psychoanalytic education that have subordinated the primary educational task to that of the training analysis. Noticing this split between education and training analysis, between cognition and affect, and between concepts of individual and group unconscious processes, we developed the Group Affective Model for teaching and learning psychoanalysis and psychotherapy in an open psychological space in which students and faculty experience individual and group processes of digestion, assimilation, and review, which demonstrate the concepts in action and make them available for internalization selectively. We discuss our philosophy and our educational stance. We describe our institution and our participants. We give examples of teaching situations that we have studied to provide some insight about assimilation and internalization of the concepts and clinical approaches being taught. We discuss the transferability of the Group Affective Model to other teaching settings and psychoanalytic training institutions and propose it as the fourth pillar of psychoanalytic training, next to analytic treatment, clinical supervision, and didactic seminars.     

The educational boundary1

In this contribution, the authors defi ne and discuss the educational boundary in analytic training, which they believe is an often neglected and useful concept in psychoanalytic education. The framework on which their discussion rests includes the recent attention of psychoanalysts to issues of boundaries and ethics. Their understanding of how clinical work affects the mind of the analyst educator, as well as the ways the personalities of various analysts affect their dealings with faculty peers and students, are the other cornerstones of their discussion. The authors contend that many of the institutional problems encountered in the training of analysts can be better understood when viewed through the prism of the educational boundary. They present examples which illustrate several of the ways psychoanalytic educators complicate the training experience of candidates, offer specifi c explanations as to why analysts struggle as they try to manage their educational interventions, and indicate in a discussion of potential remedies that those behaviors might be avoided if the educational boundary is in focus. They also provide an example of how the educational boundary can be more effectively managed.     

Connectivity and condensation in dreaming.

Converging developments in the cognitive- and neurosciences have brought Freud's hope of a bridge between psychoanalysis and psychophysiology nearer to hand. This paper concerns the relation between dream construction and memory in terms of these new developments. The neural network architecture of memory structures in the brain is described and illustrated with simple examples. We see how a network is connected and how connection weights vary with experience. The distributed representation stored by the network and its crucial properties for mental functioning are discussed. These concepts are used to explain how particular memories of past events are selected for inclusion in the dream. The properties of the neural network suggest that images of distinct past events are conflated at times during the selection process. The appearance of these conflated images may complicate the matching of day residues with representations of past events in the dream itself. Some likely implications for psychoanalytic theory are explored.     

On Teaching Psychoanalysis in Antianalytic Times: A Polemic

The author argues that in the current attitudinal climate, characterized by significant denigration of psychoanalysis coming from biologically oriented psychiatrists, academic psychologists, pharmaceutical firms, insurance companies, managed care organizations, anxious taxpayers, and revisionist critics of Freud, psychoanalysts need to adapt their training and supervisory practices to take into account the preconceptions of many of those seeking training as psychotherapists. Specifically, we need to appreciate the nature of the transferences toward analysts and analysis that exist in the wider mental health community and in the general public. These include assumptions that analysts are cold, arrogant, rigid, and worshipful toward Freud (who is himself seen as cold, arrogant, rigid, and narcissistic), and the prevalent misconception that psychoanalysis has been empirically discredited. Analysts need to find creative and honest ways, some of which are suggested by the author, to challenge the distortions in these stereotypes and to respond nondefensively and generatively to the grains of truth they contain. The essay concludes with some reminders of the legitimate strengths of the psychoanalytic tradition that suggest that its future is not as bleak as its disparagers have assumed.